title: Limited sampling strategy of mycophenolic acid in adult kidney transplant recipients: influence of the post-transplant period and the pharmacokinetic profile.
abstract: We aimed to develop an accurate and convenient LSS for predicting MPA-AUC(0-12 hours) in Tunisian adult kidney transplant recipients whose immunosuppressive regimen consisted of MMF and tacrolimus combination with regards to the post-transplant period and the pharmacokinetic profile. Each pharmacokinetic profile consisted of eight blood samples collected during the 12-hour dosing interval. The AUC(0-12 hours) was calculated according to the linear trapezoidal rule. The MPA concentrations at each sampling time were correlated by a linear regression analysis with the measured AUC(0-12). We analyzed all the developed models for their ability to estimate the MPA-AUC(0-12 hours). The best multilinear regression model for predicting the full MPA-AUC(0-12 hours) was found to be the combination of C1, C4, and C6. All the best correlated models and the most convenient ones were verified to be also applicable before 5 months after transplantation and thereafter. These models were also verified to be applicable for patients having or not the second peak in their pharmacokinetic profiles. For practical reasons we recommend a LSS using C0, C1, and C4 that provides a reasonable MPA-AUC(0-12 hours) estimation.
authors.affiliation: Department of Pharmacology, University of Medicine, Monastir, Tunisia. chaabane_amel@yahoo.fr
authors.forename: Amel
authors.initials: A
authors.lastname: Chaabane
authors.forename: Karim
authors.initials: K
authors.lastname: Aouam
authors.forename: Nadia
authors.initials: N
authors.lastname: Ben Fredj
authors.forename: Mouna
authors.initials: M
authors.lastname: Hammouda
authors.forename: Zohra
authors.initials: Z
authors.lastname: Chadly
authors.forename: Mezri
authors.initials: M
authors.lastname: El May
authors.forename: Naceur
authors.initials: N
authors.lastname: Boughattas
authors.forename: Habib
authors.initials: H
authors.lastname: Skhiri
mesh_terms: D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood* / Q000493:pharmacokinetics; D016559:Tacrolimus / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016559:Tacrolimus
keywords: kidney transplantation; limited sampling strategy; mycophenolic acid; therapeutic drug monitoring